Development of a multifaceted implementation plan to guide falls prevention in residential aged care facilities

Due to their serious consequences, falls are a well-documented problem in residential aged care facilities (RACFs). Although clinical practice guidelines (CPGs) on falls prevention in RACFs have been developed in many countries, their implementation remains challenging. Therefore, this study aimed to describe the development of a multifaceted plan for the implementation of a guideline on multifactorial falls prevention interventions in RACFs.

An implementation plan was developed as part of a large-scale falls prevention implementation initiative in Flanders (Belgium). The development process was guided by prior research and Intervention Mapping, which includes six stages: 1) logic model of the problem, 2) logic model of change, 3) programme design, 4) programme production and testing, 5) programme implementation plan, and 6) evaluation plan. A stakeholder group of nine experts actively participated in this development process. The implementation plan was pretested in six RACFs and adjusted to better align with their context.

A three-phase implementation plan divided into seven steps was finalised. The first phase is preparation (steps 1 to 3), during which RACFs undertake the necessary preparations to start the implementation process by enabling broad support within their organisation, mapping the baseline situation, defining objectives, and setting priorities. The second phase (steps 4 and 5) concerns the actual implementation, which outlines the development and performance of implementation actions. In the third phase (steps 6 and 7), RACFs evaluate and adjust actions, and aim to sustainably anchor the implemented falls prevention policy in their daily practice and quality management system.

We were able to develop a comprehensive implementation plan for falls prevention in RACFs. This plan supports RACFs in the implementation of tailored falls prevention interventions and maximise sustainability. Future research should further focus on larger-scale implementation and evaluating the effectiveness of the implementation plan in combination with the support of an external implementation facilitator. This includes assessing its impact on determinants, and implementation and clinical outcomes.